In Vitro Bursting Pressures of Jejunal Enterotomy Closures in Llamas

Abstract

To evaluate closure strength (in vitro bursting pressure) of jejunal enterotomies in llamas. In vitro experimental study. Jejunal specimens (n=72) from 6 llamas. Differences in bursting pressures and luminal diameters were compared between 2 layer enterotomy closures with an initial full thickness simple continuous pattern oversewn with either a continuous Lembert or Cushing suture pattern using 3 sizes (2-0, 3-0, 4-0) of polyglactin 910 and polydioxanone. Bursting pressures were significantly higher for enterotomies closed with polydioxanone than polyglactin 910, independent of suture size, but there was no difference between Lembert and Cushing oversew patterns. Use of a Lembert pattern reduced intestinal diameter more than a Cushing pattern regardless of suture material or size. Although polydioxanone resisted higher bursting pressures than polyglactin 910, both suture materials should be considered satisfactory for jejunal enterotomy closure in llamas based on typical intraluminal pressures expected in clinical patients. The optimal oversew pattern may be continuous Cushing to maximize the luminal diameter in small intestinal enterotomy closures. In vitro bursting pressures may help to predict which enterotomy sites would leak post-operatively, although further studies are necessary to determine the outcome in clinical patients.